Defense experts: A fall might have killed toddler

Feb. 26, 2014

Manegabe Ally

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Experts testifying on behalf of a Sioux Falls man accused of murdering a toddler say the child’s fatal injuries could have been caused by an accidental fall.

Congolese refugee Manegabe Ally, 26, has been on trial since last week for the death of 18-month old Merveil Kasangu, the son of a woman he lived with in an apartment on South Sycamore Avenue. He faces a mandatory life sentence if convicted on the most serious charge, first-degree murder.

Ally was the lone caregiver for Kasangu on Christmas Eve 2012, when he called 911 to report that the boy was not breathing. The child died in the hospital the next day, and Ally was arrested on murder charges Dec. 27.

On Tuesday, a defense expert testified that Ally’s explanation — that Kasangu fell off an adult bed and onto the floor — is as reasonable an explanation for the child’s fatal head injuries as the notion that he was beaten.

“You’re just as likely to get a depressed skull fracture from an accident as from an inflicted injury,” said Dr. Janice Ophoven, a physician hired by defense lawyers to review Kasangu’s autopsy.

Prosecutors have presented testimony for days from doctors who cared for and examined Kasangu and determined that his death was a homicide resulting from blunt force trauma.

Dr. Mina Hafzalah, the Avera McKennan Hospital pediatric physician who cared for Kasangu on Christmas Eve and Christmas Day, said the child had to be resuscitated with electricity and epinephrine at least eight times when his heartbeat stopped.

The primary injury, which caused bleeding on his brain, was a skull fracture on the back of his head. She said doctors reported the case as one of probable abuse because it seemed unlikely that a short fall from a bed to the floor could cause such a serious injury.

“The skull was basically broken and pushed inwards,” Hafzalah said.

Minnehaha County Coroner Kenneth Snell told jurors three or four areas of impact were found on the child’s skull during the autopsy.

Ophoven reviewed the autopsy and concluded that there was only one fracture to the child’s head. The other signs of injury appeared because of severe bleeding from the initial injury, she said.

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“There is no evidence of any other impact of any significance to his skull,” Ophoven said.

Another defense expert, a biomedical engineer named Chris Van Ee, showed jurors a series of slides explaining how it is possible for a child to be injured severely by a fall of 32 inches — the maximum height from which Kasangu could have fallen from the bed in the apartment.

Van Ee, who works in Ann Arbor, Mich., offered a study that found 18 child playground deaths from falls on the head during an 11-year period. The falls ranged in height from two to 10 feet.

Another study showed 15 toddler deaths from short falls, including one child who fell off a doctor’s chair and suffered a subdural hematoma, or bleeding on the brain.

Van Ee said he couldn’t find a case that exactly matched the scenario Ally used to explain Kasangu’s death, but said “it can’t be ruled out.”

“Is it common? Serious, fatal head injuries from this height? No. But as you can see from these figures, it is possible,” Van Ee said.